Since October 2002, physicians have been able to prescribe
buprenorphine to treat
opiate dependence. We examined how physicians who prescribe
buprenorphine are using it in practice to determine how well
buprenorphine has been adopted as a realistic and effective treatment option, with the ultimate goal of improved access to
opiate addiction treatment. Most prescribing physicians offer
buprenorphine in various ways, ranging from detoxification to extended maintenance, including transfer from
methadone and treatment of
chronic pain. On average, physicians write 16 prescriptions monthly, one-third of which are for new patients. The average
buprenorphine prescriber has treated 72
buprenorphine patients to date. Two-thirds prescribe for both detoxification and maintenance, allowing flexibility to meet patient needs; 19% prescribe only for detoxification, and 14% only for maintenance. Prescribing patterns are associated with experience treating addictions, patient mix, and available resources. Physicians who prescribe for detoxification only should recognize that additional resources are not necessary for maintenance, the recommended treatment for
opiate addiction. Physicians who prescribe for maintenance only would benefit from linkages with physicians or facilities that offer
buprenorphine detoxification, so patients who refuse maintenance may still be treated. With additional network development and support for physicians, access to
buprenorphine treatment can be improved.